RESUMO
We present a critical appraisal of the adaptation to the 4th European Guidelines on Cardiovascular Disease Prevention in Clinical Practice carried out by The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention (CEIPC), which is based on: 1) the removal, by the CEIPC, of important restrictions on the start of drug therapy that are contained in the European guide 2) the existence of internal contradictions and differing recommendations regarding the goals of LDL in the several publications of the CEIP adaptation; and 3) and the almost total lack of necessary discussion about risk tables in Spain. Therefore, it makes a critical appraisal of some of the most important clinical recommendations shared by the CEIPC and the European guide that are not supported by clinical evidence, like the implicit proposal of using the estimated cardiovascular risk as a target for treatment, the criteria to begin the antihypertensive drug therapy and therapeutic goals for blood pressure, LDL-cholesterol and HbA1c. The public health administration and also the scientific society must ensure transparency and independence in the drafting of documents endorsed by them, including the management and declaration of potential conflicts of interest among editors and group members. The public health administration and also the scientific society must guarantee a framework of honesty and transparency in the documents endorsed by them, with a complete declaration of the authors conflict of interests.
Assuntos
Doenças Cardiovasculares/prevenção & controle , Guias de Prática Clínica como Assunto , HumanosRESUMO
Se realiza una valoración crítica de la adaptación que ha realizadoel Comité Español Interdisciplinario para la Prevención Cardiovascular(CEIPC) de la Cuarta Guía Europea de Prevención Cardiovascularen la Práctica Clínica, que se fundamenta en: 1) la eliminaciónpor parte del CEIPC de importantes restricciones para el iniciodel tratamiento farmacológico que contiene la guía europea; 2) laexistencia de contradicciones internas y de distintas recomendacionesen las distintas publicaciones de la adaptación CEIPC respecto alos objetivos de LDL; y 3) la casi total ausencia de la necesaria discusiónsobre las tablas de riesgo en España. Además se realiza unavaloración crítica de algunas de las recomendaciones clínicas másimportantes que CEIPC y guía europea comparten y que no se sustentanen evidencias, como la propuesta implícita de la utilizacióndel riesgo cardiovascular estimado como objetivo de tratamiento, loscriterios de inicio del tratamiento farmacológico antihipertensivo ylos objetivos terapéuticos de presión arterial, LDL-colesterol yHbA1c. Sociedades científicas y Administración Pública han degarantizar la transparencia e independencia en la redacción de losdocumentos avalados por ellas, que incluya el manejo y declaraciónde los potenciales conflictos de interés de redactores y miembros degrupos(AU)
We present a critical appraisal of the adaptation to the 4th EuropeanGuidelines on Cardiovascular Disease Prevention in ClinicalPractice carried out by The Spanish Interdisciplinary Committee forCardiovascular Disease Prevention (CEIPC), which is based on: 1)the removal, by the CEIPC, of important restrictions on the start ofdrug therapy that are contained in the European guide 2) the existenceof internal contradictions and differing recommendations regardingthe goals of LDL in the several publications of the CEIP adaptation;and 3) and the almost total lack of necessary discussion about risktables in Spain. Therefore, it makes a critical appraisal of some of themost important clinical recommendations shared by the CEIPC andthe European guide that are not supported by clinical evidence, likethe implicit proposal of using the estimated cardiovascular risk as atarget for treatment, the criteria to begin the antihypertensive drugtherapy and therapeutic goals for blood pressure, LDL-cholesteroland HbA1c. The public health administration and also the scientificsociety must ensure transparency and independence in the drafting ofdocuments endorsed by them, including the management and declarationof potential conflicts of interest among editors and group members.The public health administration and also the scientific societymust guarantee a framework of honesty and transparency in the documentsendorsed by them, with a complete declaration of the authorsconflict of interests(AU)
Assuntos
Humanos , Prevenção de Doenças , Doenças Cardiovasculares/prevenção & controle , Comitê de Profissionais , Doenças Cardiovasculares/epidemiologia , Fatores de Risco , Risco AjustadoRESUMO
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Assuntos
Fatores de Risco , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Monitoramento Epidemiológico , Avaliação de Resultado de Ações Preventivas/métodosRESUMO
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